title: A questionnaire-based survey of perioperative blood conservation practice for revision hip arthroplasty in Scotland.
abstract: The aim of this study was to describe current blood conservation practice during revision hip surgery in Scotland and document practice variation. Revision hip surgery is associated with a high likelihood of blood transfusion. A decrease in the proportion of patients requiring blood transfusion has been documented, but the reasons for this are unclear. Various blood conservation practices are available to clinicians, but the extent to which these are used in Scottish hospitals is not known. A cross-sectional postal survey was sent to all consultant orthopaedic surgeons and consultant anaesthetists participating in revision hip surgery in Scottish hospitals. Responses were received from 92 of 120 (77%) surgeons, and 174 of 216 (81%) anaesthetists (62/92). A total of 62 of 92 (67%) surgeons and 78 of 174 (45%) anaesthetists surveyed participated in revision hip surgery. Blood conservation practice varied widely: 34 of 78 (44%) anaesthetists routinely assessed revision hip patients >or=1 week prior to surgery; 10 of 62 (16%) surgeons and 24 of 78 (31%) anaesthetists routinely used cell salvage; 7 of 78 (9%) anaesthetists and 2 of 62 (3%) surgeons routinely used tranexamic acid; and 45 of 62 (73%) surgeons use a transfusion protocol. A wide variation in the use of blood conservation strategies exists during revision hip surgery in Scotland.
authors.affiliation: Better Blood Transfusion Programme, Scottish National Blood Transfusion Service, Royal Infirmary of Edinburgh, Edinburgh, UK. mairi.harkness@snbts.csa.scot.nhs.uk
authors.forename: M
authors.initials: M
authors.lastname: Harkness
authors.forename: J B
authors.initials: JB
authors.lastname: Palmer
authors.forename: D
authors.initials: D
authors.lastname: Watson
authors.forename: T S
authors.initials: TS
authors.lastname: Walsh
mesh_terms: D000758:Anesthesia / Q000379:methods; D000776:Anesthesiology / Q000706:statistics & numerical data; D000933:Antifibrinolytic Agents / Q000008:administration & dosage; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data*; D016063:Blood Loss, Surgical / Q000517:prevention & control / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data*; D002469:Cell Separation / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D006306:Health Surveys; D006452:Hemoglobinometry / Q000706:statistics & numerical data; D006801:Humans; D007501:Iron / Q000008:administration & dosage; D009985:Orthopedics / Q000706:statistics & numerical data; D011182:Postoperative Care; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011300:Preoperative Care; D012086:Reoperation / Q000379:methods / Q000706:statistics & numerical data; D012606:Scotland; D011795:Surveys and Questionnaires; D014148:Tranexamic Acid / Q000008:administration & dosage
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid; D007501:Iron